NURS 6531 Final Exam 1 Q&A

NURS 6531 Final Exam 1 Q&A 1. When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? YES 2. Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis? Macrocytic anemia 3. A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Overweight 4. The most effective intervention(s) to prevent stroke is (are): Smoking cessation and treatment of hypertension 5. Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long-term pain relief? Physiotherapy modalities 6. An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? Hypoglycemia 7. Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is: Diabetes Mellitus 8. Prolonged PT suggests Liver disease, DIC (early), Warfarin, Factor VII deficiency 9. Diagnostic radiological studies are indicated for low back pain: Xray 10. An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient’s pain is: Hydrochlorothiazide 11. Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus? Post-prandial hypoglycaemia 12. Maria, age 17, was raped when she was 13-year-old. She is now experiencing sleeping problems, flashbacks, and depression. What is your initial diagnosis? Post-traumatic stress disorder 13. A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis? Hallucinations 14. Which of the following statements about multiple sclerosis (MS) is correct? A (Cause demylenation of nerve axons) & B (Affects women 2-3X more than men) 15. Which patient would benefit most from screening for type 2 diabetes? Person with HTN A person who is physically inactive A person with polycystic ovarian syndrome 16. Differential diagnosis of proteinuria includes which of the following (A and B) Orthostatic proteinuria & Nephrotic syndrome 17. A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: Primary hyperparathyroidism is treated with parathyroidectomy 18. A middle-aged man presents to urgent care complaining of pain of the medial condyle of the lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam, the medial epicondyle is tender, and pain is increased with flexion and pronation. Range of motion is full the most likely cause of this patient’s pain is: Epicondylitis 19. What intervention does the American College of Rheumatology recommend as first line therapy for osteoarthritis? Exercise and weight loss 20. The cardinal sign of infectious arthritis is: Affected joint is painful at rest, with movement and weight bearing 21. Legal authority for advanced practice nursing rests with: The state laws and regulations 22. The nurse practitioner diagnoses epididymitis in a 24-year-old sexually active male patient. The drug of choice for treatment of this patient is: Doxycline 23. A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner’s recommendation Recommend that the patient continue the antidepressant medication for at least 4 more months 24. Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? Peppermint 25. Risk factors for prostate cancer include all of the following except: History of genital trauma 26. An obese hyperlipidemic patient, newly diagnosed with type 2 diabetes mellitus, has fasting glucose values 180 to 250 mg/Dl. What is the most appropriate initial treatment to consider? A sulfonylurea and/or metformin (Glucophage® -XR) 27. The primary goals of treatment for patients with alcohol abuse disorder are Reducing substance abuse or achieving a substance-free life Maximizing multiple aspects of life functioning, Preventing or reducing the frequency and severity of relapse 28. What is the most commonly abused substance? Alcohol? Marijuana? Tobacco/nicotine? 29. Central obesity, “moon” face, and dorsocervical fat pad are associated with Cushing Syndrome 30. Reed-Sternberg B lymphocytes are associated with which of the following disorders: Hodgkin’s lymphoma 31. Which of the following symptoms suggests a more serious cause of back pain? Pain associated with lying down at night 32. The Institute of Medicine’s recommended daily allowance (RDA) for Vitamin D in adults over age 70 years of age is: 800 IU daily 33. Potential causes of septic arthritis include which of the following? A and B (Lyme disease and prosthetic joint infection) 34. Which of the following characteristics are associated with prepatellar bursitis? Repetitive bone (knee) trauma 35. A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: Olcreanon bursitis 36. The initial clinical sign of Dupuytren’s contracture is: Painless nodule on palmar fascia 37. A patient complains of generalized joint pain and stiffness associated with activity and relieved with rest. This patient history is consistent with which of the following disorders? Osteoarthritis 38. Risk factors for osteoporosis include: Rheumatoid arthritis 39. Which of the following symptoms suggests a more serious cause of back pain? Pain associated with negative straight leg raise 40. A 60-year-old gentleman complains that he is tired of having “gout attacks” and asks what he can do to stop the attacks. Which of the following medications can be used to lower uric acid and treat chronic gout? C and D (Zyloprim & Febuxostat) 41. Potential causes of septic arthritis include which of the following? All of the above (Lyme Disease, Prosthetic joint infection, Reiter’s syndrome) 42. The most effective treatment of non-infectious bursitis includes: Conservative treatment includes rest, cold and heat treatments, elevation, administration of nonsteroidal anti-inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections 43. What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? The physician must be on-site and engaged in patient care You must initiate the plan of care for the patient 44. Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus? The metabolic syndrome refers to the co-occurrence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia and hypertension. 45. Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? Strong urinary stream flow 46. Which drug category contains the drugs that are the first line Gold standard therapy for COPD? Beta antagonist 47. The most commonly recommended pharmacological treatment regimen for low back pain (LBP) is: NSAID 48. Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Erythromycin 49. You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: he Cruciate ligament 50. A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? Obtain a thorough history and physical, and check serum cortisol and ACTH levels